Endoscopy in Urology

An advanced minimally invasive method of removing kidney concretions without additional punctures and incisions using access exclusively through the natural urinary tract. A special casing protects the ureter, through which a flexible endoscopic instrument with a diameter of less than 3 mm – a fibroureteropieloscope – is passed into the renal cavity. With its help, the stone becomes available for destruction by holmium laser. The remaining large fragments are freely extracted outside using special nitinol baskets. At the end of the operation, an internal drainage is installed and the patient can return to normal life after discharge the next day from the hospital. This method is a leader in the arsenal of the world’s leading expert-class clinics specializing in the treatment of urolithiasis.

This method is widely used at the N. Lopatkin Scientific Research Institute of Urology and Interventional Radiology to remove most large and multiple kidney stones with minimal risk of complications. When working with this instrument, the most modern high-power holmium laser is used, which can quickly turn the stone into sand. This technique is minimally traumatic (puncture diameter of about 5 mm), perfectly tolerated by patients (minimal pain and discomfort) and is highly effective in the treatment of urolithiasis. The peculiarities of the technology allow the intervention without leaving the external nephrostomy drainage.

The passage into the kidney made through a skin puncture is securely closed with a special matrix that seals the channel and contains powerful blood-stopping factors. This minimizes the risk of bleeding and other complications. Patients recover quickly in the postoperative period and can return home as early as 2-3 days.

The most complex kidney stones – coral stones occupying all parts of the collecting system are effectively and quickly removed in the clinic of the N. Lopatkin Scientific Research Institute of Urology and Interventional Radiology using the patented author’s technique of biportal percutaneous nephrolitholapaxy, which has no analogues in the world. During the operation, two surgeons simultaneously work with the stone through miniaturized accesses, providing a synergistic effect. Thus, the operation time is reduced by 40%, low fluid pressure inside the kidney is ensured, and the risk of complications is reduced by 2 times. Patients have a high chance of getting rid of a complex stone without prolonged treatment with repeated operations and additional methods of stone destruction.

Every year, specialists of the N. Lopatkin SRIUIR perform more than 700 high-tech interventions for the treatment of large and coral kidney stones. 75% are complex cases requiring expert-class surgical intervention.

Minimally invasive treatment of prostate adenoma is another important area of work at the N. Lopatkin Scientific Research Institute of Urology and Interventional Radiology. The clinic specializes in the treatment of the most complex cases of this pathology, represented by large prostate volumes exceeding 100 cm3, often in combination with large bladder stones. In this situation, patients often cannot find a solution for minimally invasive removal of hyperplasia and bladder stones in a single intervention. The most modern 100W holmium laser available at the N. Lopatkin Scientific Research Institute of Urology and Interventional Radiology, combined with decades of experience in endoscopic surgery, allows us to quickly and effectively remove adenomatous tissue and stones of any volume through the urethra without any incisions. Patients fully recover within 3-4 days after surgery and return to their normal life.

N. Lopatkin Scientific Research Institute of Urology and Interventional Radiology has a full arsenal of means for endoscopic treatment of narrowings (strictures) of the urethra. Scar tissue can be effectively dissected endoscopically, vaporized with a laser. In case of impossibility to perform urethral plasty, we have extensive experience in the installation of intraluminal stents of various designs, allowing to restore and facilitate independent urination.

Endoscopic treatment of ureteral and renal tumors without their removal is one of the most technologically advanced techniques in oncourology. In situations with bilateral lesions, single and only-functioning kidneys, the technique of endoscopic laser removal of neoplasms is practically non-alternative. The N. Lopatkin Scientific Research Institute of Urology and Interventional Radiology develops and successfully applies transurethral and percutaneous approaches to laser ablation of tumors. The result is the achievement of good control over the oncologic process while preserving the kidneys.